The number of bariatric surgeries has grown markedly in recent years, increasing more than 400% between 1998 and 2002. In 2010, the number of obese patients undergoing weight loss operations in the US was estimated to be over 200,000. Furthermore, it is projected that approximately one in four bariatric surgeries will be performed using an open laparotomy technique.
The overall major complication rate for open bariatric surgeries is 4% and the overall minor complication rate is 22%. For example, complications of open bariatric surgeries include wound infection and acute wound failure, such as incisional hernia formation. Wound infection is a recognized risk factor for incisional hernia formation. The formation of an incisional hernia results in re-operation of patients almost 100% of the time. Incisional hernia rates have been reported to be 8.9-21% in open bariatric surgeries, and 11% of laparotomy wounds fail and result in the formation of an incisional hernia. The rate of incisional hernia formation is therefore 9-22 times higher in patients undergoing bariatric surgery procedures compared to patients undergoing non-bariatric surgery procedures.
The incidence of wound complication rates is likely related to the obese state of the patients undergoing the bariatric surgery procedures. Previous reports suggest that obese patients have impaired tissue repair compared to non-obese patients. For example, prolonged or increased inflammation in the obese state could contribute to a delay in wound healing due to by a failure to progress to normal fibro-proliferation. Moreover, the obese state could cause an increase in wound failure due to the high mechanical loads placed on the abdominal wall, as well as impaired laparotomy wound healing.
Therefore, a method to prevent acute wound failure and incisional hernia formation associated with bariatric surgeries is disclosed. Methods are described herein for preventing acute wound failure and incisional hernia formation using a composition including basic fibroblast growth factor. Basic fibroblast growth factor is a polypeptide known to exhibit biological activities such as stimulation of cell mitogenesis and chemotaxis.
The methods described herein demonstrate that acute wound failure and incisional hernia formation can be prevented by using a therapeutically effective amount of a composition comprising basic fibroblast growth factor. Through administration during a bariatric surgery, the methods overcome the problems associated with wound complications in an obese patient population following bariatric surgical procedures.